胃乳头状腺瘤甚少见,巨大乳头状腺瘤更属罕见,今我科遇有一例,报告如下: 患者陆××,男性,72岁。纳差,消瘦二个月。近年来多次出现上腹部隐痛不适,入院前一个月曾无明显诱因呕吐一次,为少量胃内容物。体检:腹部平软,无压痛,来扪及包块。脱落细胞检查:未查见腺癌细胞。纤维胃镜检查:自小弯至窦部前段可见分叶状不规则核桃大小、质软易脆新生物,表面不平。有一处溃疡及出血,底部似有蒂,胃壁及胃窦粘膜尚光滑,幽门尚能开放有蠕动。胃粘膜活检诊断:胃腺癌。行胃癌根治术,结肠前胃空肠吻合术,脾切除术。 Stomach papillary adenomas are rare, and giant papillary adenomas are even rarer. Now our department has one case and the report is as follows: Patient Lu X, male, 72 years old. Anorexia, weight loss two months. In recent years, there have been many episodes of discomfort in the upper abdomen. There was no obvious inducement of vomiting once a month before admission. It was a small amount of stomach contents. Physical examination: The abdomen is soft, no tenderness, and palpable masses. Exfoliated cell examination: No adenocarcinoma cells were examined. Fiber gastroscopy: From the small curve to the front of the sinus can be seen lobular irregular walnut size, soft and brittle new creatures, the surface is not flat. There is an ulcer and bleeding, the bottom seems to have pedicles, gastric wall and gastric antrum mucosa are still smooth, pyloric can still open peristalsis. Gastric mucosal biopsy diagnosis: gastric adenocarcinoma. Radical gastrectomy, anterior colonic gastrojejunostomy, splenectomy.